February 10, 2017
Community Benefits Rise Again
Excuse the bad headline pun - community benefits are indeed on the rise, literally, as hospitals invested a record $1.6 billion last year, and figuratively, as the tax exempt issue is once again on the rise in Annapolis.
At a hearing yesterday before the House Health & Government Operations Committee, I was joined by Dr. Sam Ross, President & CEO of Bon Secours Health System, Martha Nathanson, Vice President of Government Relations and Community Development for LifeBridge Health, and TJ Sullivan of Drinker Biddle, a federal tax law expert. We defended hospitals' tax exempt status against SEIU, which wants to chip away at it by suggesting that the value of tax exemption exceeds the value of community benefits.
This is a comparison that is not only faulty on its face, but supports a direct assault on hospitals' tax-exempt status. Already a bill has been introduced that would mandate that hospitals report the value of their tax exemptions alongside the value of their community benefits.
But, as you know, community benefits are just a part of the overall charitable purpose of not-for-profit hospitals. And a major reason for the hearing yesterday was so we could clear up some common confusion about tax exemption. In other states, like New Jersey and Illinois, politicians' lack of understanding of tax exemption, community benefits, and not-for-profit status has been a factor that led to new tax assessments for some hospitals.
At the hearing yesterday, we reminded legislators that not-for-profit status (how organizations are incorporated in state law) is different from tax-exempt status (an IRS designation given to organizations that operate for a charitable purpose). Community benefits, of course, are simply a method to publicly report some of the activities in which hospitals engage that demonstrate their larger charitable purpose.
Despite the imperfect comparison, one of the positive messages that legislators heard yesterday came from the author of a study who, contrary to SEIU's premise, confirmed what you already know: the value of the community benefits Maryland's hospitals provide far exceeds - by two-and-a-half times - the value of their tax exemption.
You know what this tax exemption means to your hospital and your community: it means, in almost every case, survival. Imagine the financial situation your organization would find itself in if suddenly the tax man came knocking at the door! Imagine the services and jobs that you would have to cut. Imagine, for the people across Maryland, how much hospital rates would soar in an attempt to keep hospital care alive.
The impact of taxing hospitals as if they were for-profit entities would be so damaging that it's hard to fathom why the issue is even up for discussion. But that's why it is so important that MHA spend significant time and energy to proactively counter efforts that question the value you provide to your communities: so that we don't even venture onto the slippery slope that this debate could lead to.
Hospitals do wonderful things every day, inside and outside their walls. Tax exemption allows much of that to happen. We will continue to engage legislators, to help them understand that it is their constituents and their communities that reap the benefits. 

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February 14
February 14
February 15
February 16
At Work in Annapolis
Because today is the deadline for the House of Delegates to submit bills for consideration (the Senate deadline was last Friday), the vast majority of bills that will be considered this session will be publicly available by early next week. MHA continues to review a substantial number of bills that could affect the hospital field. This week, MHA led a panel presentation before the House Health & Government Operations Committee on hospital community benefits. Unexpected legislation that would combine the Health Services Cost Review Commission and Maryland Health Care Commission also was introduced this week, and MHA is working to determine the full implications of that proposal. Links to bills and our position papers are included in each week's Advocacy Dashboard.
HSCRC Acts on QBR Recommendations
Health Services Cost Review Commission members this week approved staff recommendations on the fiscal year 2018 and 2019 Quality Based Reimbursement program, supporting the recommendation to discontinue the exclusion for palliative care cases in the mortality portion of the calculation, over MHA's objection. Commissioners also received a report on current legislative activity affecting the commission, as part of a busy monthly meeting agenda. Read more about this month's meeting in Newsbreak.
HHS Alerts to Possibility of 'Lone Wolf' Terror Attacks
The Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response (ASPR) is urging hospitals and other health care facilities to continue to be alert for potential "lone wolf" terror attacks. ASPR issued a similar warning just before New Year's Eve, noting that ISIS had recently encouraged its followers in the U.S. to perpetrate such attacks over the holiday. In an alert to its members this week, the American Hospital Association (AHA) shared with hospitals this document from the Department of Homeland Security, Federal Bureau of Investigation and National Counterterrorism Center. The document outlines possible indicators of the targeting of hospitals and health care facilities and possible mitigation strategies facilities can take. AHA reminded hospitals to review security measures in place at their facility as well as their Hospital Incident Command System.
MHCC Releases Hospital Health IT Report
The Maryland Health Care Commission has released its annual report on health information technology among acute care hospitals. A copy of the report is available here. The report identifies current trends and the future direction of health IT use among hospitals in Maryland and nationally.
AHA Seeking Trustee Candidates
The American Hospital Association is seeking qualified trustee candidates for several committees. Involvement with these committees, regional policy boards, and specialty councils is an ideal way for a trustee to provide input on health policy development at a national level. The committees and boards looking for trustees are:
  • Committee on Governance: a national committee composed of trustees
  • Regional Policy Boards: regional committees composed of CEOs, physicians and trustees
  Candidate applications are due February 23, 2017, and the positions would begin in January 2018. More information can be found at: www.aha.org/trusteeopportunities .
Applications Being Accepted for Foster G. McGaw Prize
The Foster G. McGaw Prize was created in 1986 by the American Hospital Association and the Baxter Allegiance Foundation to recognize hospitals that have distinguished themselves through efforts to improve the health and wellbeing of everyone in their communities. The prize was founded on the belief that the relationship between a hospital and its community is unique. Past winners and finalists of this award have shown how people working together in hospitals and communities can enrich the environment in which they live. Applications for this award must be received by April 7. More information and the application details can be found at AHA's website.
Hopkins Offers Webinar on Preventing Incorrect Diagnoses
The Johns Hopkins Armstrong Institute for Patient Safety and Quality is offering a free webinar March 1 at 1 p.m. on Diagnosis as a Team Sport. Participants will learn how all members of the care team - nurses, allied health professionals, patients and family members - can help prevent incorrect or missed diagnoses.
Discussion topics will include:
  • The benefits of teamwork in diagnosis
  • How to involve nurses and allied health professionals as critical members of the diagnostic team
  • Ways to engage patients so that they contribute to accurate diagnoses
  • Legal, cultural and logistical barriers to diagnostic teamwork
Registration is required for the free webinar. 
Change is Rapid, Successful Change Takes Time
National management and leadership expert Robert Tanner likens the common failure of organizational change efforts to the traveler on the side of the road with a gas can in his hand, a stalled vehicle and unhappy family members in the car: "organizational change efforts run out of gas before the organization ever reaches its desired goals."

Reduce Lighting Energy Costs Up to 50 Percent
Lighting accounts for 30 to 60 percent of annual electric costs for many facilities, and many new advances in lighting technology can help your organization conserve energy and save money.

AHRQ Releases ICU Mechanical Ventilation Safety Toolkit
The Agency for Healthcare Research and Quality recently released a toolkit to help hospital intensive care units prevent ventilator-associated pneumonia and other complications for patients on mechanical ventilation. 

Monday, February 13
MHA Council on Legislative & Regulatory Policy meeting (conference call)

Tuesday, February 14
MHA Council on Clinical & Quality Issues meeting
Capital Gazette, By Amanda Yeager, February 4
ABC 2 News, By Mallory Sofastaii, February 3
WCBC Radio, February 6
Baltimore Business Journal, By Morgan Eichensehr, February 6
ABC 2 News, By Brendan McNamara, February 8
Salisbury Independent, By Greg Bassett, February 8
WYPR's On the Record, By Sheilah Kast and Maureen Harvie, February 8